Blog

Nervousness on the first day of school is perfectly normal both for parents and young students. New routines, new people, new information: it’s a time of transition. But “transition” doesn’t have to be a bad word.

Nancy Zinaman, LCSW, shares some simple back-to-school preparation tips that will make the first day easier on the entire family:

For kindergartners try not to make the first day over emotional. If parents are anxious they need to be aware of their own feelings so as not to make their children more nervous.

Children who have made a smooth transition into preschool may have a harder time transitioning into Kindergarten. You can help make this transition easier by playing on the school playground with your child before classes begin. Visit the school when it
is empty or schedule a tour. If time allows, visit or arrange a one-on-one meeting with the teacher and staff. Familiar faces and places will make the first day so much easier.

For children with special needs it’s important for parents to connect with teachers prior to the first day of class to make sure they are aware of separation anxiety, ADHD or any other family challenges

Find out the best way to communicate with your child’s teacher. Ask your child’s teacher what he or she would prefer: email, phone, etc. This will foster a positive, productive relationship from the start.

Prepare for the new routine early. Don’t wait until the first day to start implementing your new routine. Put the school day structure in place one or two weeks before: establish a back-to-school bedtime; get up early; give kids a fun school-day
task like packing their own lunch or backpack. Don’t over-schedule after school activities the first couple of weeks because your children will be tired after a long day of school.

Talk to your children. Find out how your children really feel about starting a new school year. Is there something in particular that is causing nervousness or dread? Give yourself time to address it or talk to the school about it if it’s
something the school can address. Let your children know their feelings are normal and that they are not alone.

Remember the last time you had a good laugh? How about that feeling of amusement you get when you anticipate witnessing something
funny? Mirth—otherwise known as merriment and glee—has been the recent subject of research. While still in its infancy, some of the studies’ early results might surprise you.

John Chamness, a licensed massage therapist at NorthShore’s
Integrative Medicine program lists some of the recent findings behind mirth. After watching funny movies, participants experienced the following health benefits:

Significantly lowered risk of a second heart attack in men who combined watching 30 minutes a day with standard cardio rehab

Increased beneficial blood vessel relaxation

Influenced the expression of genes, including turning on genes related to immune function

Reduced water loss from skin in elderly men with atopic dermatitis (dry skin)

Short-term improvement of erectile dysfunction

Are these the effects of the state of mirth, or the laughter that is often a result? Regardless, you don't have to wait for something funny to enjoy a laugh; laughter can be prolonged as a deliberate behavior.

In Laughter Yoga—a social movement that began in India and is catching on here—participants alternate 45 – 60 seconds of deliberate, sustained laughter with deep breathing and brief stretching for a total of 30 minutes. After seven sessions over three weeks,
Laughter Yoga participants had significantly lowered their blood pressure.

During sustained laughter (through Laughter Yoga or not), the diaphragm increases from working an average of 12 times per minute during regular breathing to 300 forceful times per minute. Over 20 minutes of sustained laughter accounts for 6,000 contractions.
That’s quite a workout!

So, what’s the key take away? Be serious in your pursuit of health, but don't always pursue health with seriousness.

What makes you laugh? Have you ever participated in a Laughter Yoga session?

As a woman, regular visits to the obstetrician/gynecologist are an important way to establish a long-term, trusting relationship with your clinician. They are also an opportunity to regularly review your medical history and evaluate your current health through
various screenings, including a breast exam, mammogram or pelvic exam.

Despite recent headlines from the American College of Physicians (ACP), a screening pelvic exam as part of
your well woman visit is important for women both with and without symptoms. While a pelvic exam and/or breast exam may be moderately uncomfortable or even embarrassing for some, its enormous possible health benefits make it an essential appointment for every
woman.&

A well woman visit does not consist solely of a pelvic exam or breast exam; instead these visits are an opportunity for women to have open conversations with their physicians and learn helpful information about their bodies and anatomy. They can lead to
the early detection of issues ranging from benign conditions like pelvic support and pain to sexually transmitted infection; ovarian, cervical, vaginal, skin and breast cancers; fibroids and more.

Carl Buccellato, MD, Gynecologist at NorthShore, shares information about what you should expect from a yearly well woman visit:

Open conversation. It’s important so come prepared to have a frank conversation about contraceptive and preconception counseling and safe sex practices with your doctor.

Discussion about your state of health. Just like your yearly visit with your primary care physician, you will discuss any recent changes to your health, concerns from the last year and updates to your medical history.

Medications. Bring a list of your current medications, including any birth control.

Breast examination. A breast exam should happen at each of your yearly appointments starting at age 21. If you notice any changes to your breasts from self-examination, please inform your physician.

Pelvic exam. A pelvic exam is typically performed at each annual visit, and will not always include a Pap smear. A pelvic exam consists of both an external and internal visual exam as well as an evaluation of your uterus and ovaries through
a manual exam, which should take no more than 2-3 minutes. You may feel some pressure and mild discomfort during this exam but it should not be painful.

Pap smear. You should consult with your physician on the best recommended schedule for this test. The timing of your Pap smear will depend on your age, health and medical history. We recommend you get your first Pap smear by age 21. It
is commonly then performed every 3 years until you are 30, and every 3-5 years thereafter.

You should always be proactive about scheduling more frequent appointments and undergoing screenings if you have previously had abnormal test results from a Pap smear; family history of uterine or breast cancer; and/or any recent changes in health such as
infection, pain or bleeding.

Studies performed by NorthShore researchers suggest a painful pelvic exam is one marker of chronic pain issues. It may be important to address this issue with your OB/GYN physician before chronic pain develops. This NIH-funded research study Chronic Pain
Associated with Menstrual Pelvic Pain (CRAMPP) is being done by investigators Frank Tu, MD, and Kevin Hellman, PhD.

While more research has yet to be conducted, a painful exam may not be entirely normal. If you experience pain and/or moderate-to-severe discomfort during your pelvic exam, please inform your OB/GYN physician.

Richard (Tom)
Thomson, PhD, Director of the Microbiology Laboratory and Division Head of Clinical Pathology at NorthShore, provides answers to some common questions regarding the Ebola virus:

How is it transmitted?It is not known to be airborne. Ebola is passed through direct contact with bodily fluids and specimens from patients infected with the virus. So it is family, caretakers and healthcare workers with close contact to an infected person who face the
greatest risk if they don’t take the right precautions.

Can you contract Ebola from contact with someone who does not exhibit any symptoms? No. An individual who is infected but not exhibiting symptoms is not contagious. If a person is symptomatic, he or she can spread the virus but only through direct contact with bodily fluids, such as blood. So, as an example, if you were sitting next
to someone on a plane who developed symptoms of Ebola a week or 10 days later, you were not at risk for infection because they were asymptomatic at the time.

How are American healthcare workers being infected with the virus?Unfortunately, the ability of healthcare workers in Africa to protect themselves is different from the ability of healthcare workers to protect themselves in the United States. They do not have the facilities that we have here in this country. In the
U.S., we have the facilities and training to handle many different infections of various risks. And while Ebola presents one of the greatest risks to healthcare workers, we have procedures in place that will be used to handle any Ebola patients who enter the
country.

How is the spread of the virus to the United States being prevented?The Centers for Disease Control (CDC) and the World Health Organization (WHO) have specific procedures in place to follow if they feel that someone on a plane is symptomatic. That person would arrive in the United States and be put immediately in the
appropriate containment in one of our hospitals. They also have screening efforts ongoing in West Africa to prevent symptomatic persons from getting on planes. By following those procedures, the spread of the virus into the United States is very unlikely.

Meeting your required daily intake (RDI) of vitamins and minerals is essential to maintaining your current health and staying healthy later in life. However, nearly the entire U.S. population is at risk for vitamin and mineral deficiency. Achieving your
RDI doesn’t have to be difficult. In fact, a eating a healthy, varied diet makes getting important vitamins and minerals, like vitamin A, B9, B12, C, D, E, calcium, magnesium, zinc and potassium, both simple and delicious.

What should you be eating and why? NorthShore University HealthSystem has created an infographic that breaks down the health benefits of important vitamins and minerals, as well as includes a list of foods high in these vitamins. Click on the image below
to view our
full infographic and then add these superfoods to your grocery list.

Are stomachaches and messy potty breaks frequent occurrences for little ones in your home? “Stomach problems” happen to
everyone, and children are no exception. Sometimes an upset tummy is just an upset tummy, but children, just like adults, can suffer from food allergies and sensitivities, and just like adults these allergies and sensitivities can and should be addressed.

Vincent Biank, MD, Pediatric Gastroenterology at NorthShore, answers some common questions about GI food allergies and sensitivities
in children:

Is there an easy, relatively non-invasive test to see which foods a child is allergic or sensitive to?There are several simple blood tests for allergies but unfortunately we do not have simple tests for sensitivities that are accurate in children; therefore, we will commonly have to do an elimination diet. We will remove one food item at a time for
two weeks and then replace that food item after those two weeks, carefully documenting any changes in the symptoms. The two most common sensitivities are lactose and gluten. I would not recommend removing gluten from a child’s diet until they have been properly
tested for Celiac disease otherwise you will just need to add it back in for one to two months before it can be accurately checked in the blood.

What foods are typically off-limits for child with soy and dairy allergies? Is it possible to eliminate these foods entirely from a child’s diet?Soy and diary are in almost everything, so eliminating them is difficult. For this reason, we will have our pediatric dieticians work with families to make sure no soy or dairy in getting into a patient’s diet. Until then, check labels! Anything that
has soy, soy protein, milk, milk protein, casein or whey in its label should be avoided.

Are children with GI food allergies more likely to develop other GI-related issues as young adults and adults? Unfortunately we don't have enough data to answer this question at this time. Although food allergy with typical symptoms of anaphylaxis, hives, trouble breathing etc. has been diagnosed and treated for many years, the majority of the GI manifestations
of food allergy are recent in their discovery. For example it wasn't until 1995 that Eosinophilic Esophagitis was even considered a diagnosis and now we are diagnosing it one to two times per week. The result is we still don't have a clear idea of the natural
history of GI food allergies over time.

Should children with stomach “issues” be given probiotics, as well as brought in for testing? The short answer is to go ahead and try probiotics prior to the visit. The long answer is that unfortunately we are only at the beginning of our understanding of what probiotics do, such as which varieties are best, how much to give and how long they
should be taken.

What are some of the warning signs of GI issues in toddlers/children? Should a parent be concerned about frequent loose stools?The biggest sign of GI issues is poor weight gain. Diarrhea can be a symptom of an underlying GI disorder but not always. We frequently see toddlers with loose stools with no additional systemic signs of disease, like poor weight gain; therefore, we
will typically rule out some common GI-related problems. If tests are negative, we will then discuss how to thicken the stool.

Are the foods known to cause GI allergic reactions in kids the same as those that cause skin or more severe allergic reactions? What are the common foods for GI allergies?Yes, for some individuals the foods that cause GI allergic symptoms could also cause skin and the typically more severe allergic reaction; however, this is not the case for everyone. Some individuals will only have GI symptoms and others will only
have skin or respiratory symptoms. The most common foods for GI allergies are the “Big Six:” milk, soy, wheat, eggs, nuts and fish.

Does your child have a food allergy or sensitive that results in GI issues?

The kids are home from school for the summer, so accidents are bound to happen. Some injuries can be treated from home
with the help of a first aid kit but some could require a visit to the emergency department. Make sure you are treating those bumps and bruises at home the correct way or know for sure you should be getting into the car and heading to the emergency department
instead.

Ernest Wang, MD, Emergency Medicine at NorthShore, dispels some common myths with the help of the facts:

Myth: Put your head back when you have a nosebleed.Fact: Don’t put your head back! Blood could flow down your throat and potentially into your stomach, which can cause nausea and vomiting; instead, tilt your head forward and pinch your nose right at your nostrils, not higher. Hold your nose
for a full 10 minutes before checking to see if the bleeding has stopped. If bleeding lasts much longer or if the bleeding was the result of an injury, head to the emergency department.

Myth: Help soothe and heal a burn by applying butter.Fact: Butter could make the burn worse and make treatment by a doctor more difficult. Putting butter on a burn means putting a non-sterile substance on an extremely sensitive area that is highly susceptible to infection. First-degree burns
can be treated at home using cool, but not cold, water. Hold the burn under running water for approximately 10 minutes or until there is some relief of pain. Severe burns—second-degree and third-degree burns that exhibit blistering, swelling and intense pain—must
be treated by a physician.

Myth: Put cold red meat on a black eye.Fact: It’s the cold, not the steak, that’s important. Unless the steak is frozen and sealed completely, you don’t want that on any bruise—eye or otherwise—because it could introduce bacteria into the equation that could result in an infection.
Grab a bag of frozen peas or a cold compress of some kind instead; it will help with swelling.

Myth: Apply a hot compress to a sprained ankle.Fact: Cold is the best way to combat swelling. Heat could actually worsen the inflammation of the injury. For ankle sprains, apply a cold compress for a full 10 minutes and then continue to apply cold as needed. For severe sprains, strains
and fractures, seek immediate attention in the emergency department.

Myth: A choking victim will require the Heimlich maneuver. Fact: A choking victim might require the Heimlich maneuver for a complete blockage of the airway but you will have to keep your composure long enough to find out if that is the case. If the choking victim cannot speak and is turning blue, the
Heimlich maneuver is required to allow air to push the obstruction out of the airway.
Call 911 immediately and ask for help. If the victim can talk, it is a partial blockage, which can likely be resolved with coughing.

What’s growing in your herb garden this summer? Healthy, flavorful sage isn’t just for seasoning meats, though it has that reputation.
The subtle flavor and distinctive scent can elevate healthy, vegetarian-friendly recipes too. If sage is a standout among your summer crops, we have the perfect recipe for potlucks, barbeques and quick-fix dinners.

Choosing the right birth control method can be difficult; there are a variety of options available and nearly
every type can affect different women in different ways. Ultimately the best method for each individual woman will be the one that doesn’t cause side effects that disrupt and impede normal daily activities and one she will use consistently.

Diana Atashroo, MD, Obstetrics and Gynecology at NorthShore, discusses how birth control works, as well as birth control options
and possible benefits beyond pregnancy prevention:

Hormonal birth control, often referred to as “the pill,” contains estrogen and progestin. Birth control reduces the risk of pregnancy by inhibiting ovulation, or the time during a woman’s cycle when a mature egg leaves the ovaries. The pill also causes a
thickening of the mucus of the cervix making it impenetrable to sperm and keeping the lining of the uterus thin.

Birth control options include:

Hormonal methods:

A pill (typically a combination of estrogen and progestin, though progestin-only is also available.

Skin patch changed weekly

Injection given every three months

Vaginal ring changed every month

Implanted devices (with and without hormones):

Implant under the bicep for up to three years

Intrauterine device (IUD) for between five to ten years

Health Benefits:
The most common use of oral contraception is the prevention of pregnancy. While the daily contraception pill is the most popularly used and prescribed medication, the most effective method is the implanted devices. With appropriate use of these methods of contraception
they are 99% effective.

However, birth control is not prescribed or taken exclusively for the prevention of pregnancy. There are several benefits to hormonal birth control, and many women choose to take it for these reasons:

PMS symptom relief. Hormones have been shown to provide significant relief of many of the symptoms of premenstrual syndrome, including menstrual cramps, headaches, depression, heavy or irregular periods and hormonal acne.

Making connections with patients, with entire families, is what Matthew Plofsky, MD, Family Medicine
at NorthShore, enjoys most about his chosen specialty. Not only does he get the chance to help his patients feel better and stay better, but he can watch his littlest patients grow up and his patients’ families grow larger as he provides care over the years.
As a child, his own pediatrician was not simply a doctor; he was a warm, caring man who took the time to develop a relationship with the whole family. This example, as well as his mother’s efforts as a nurse for over 40 years and a desire to be challenged
by his career, led Dr. Plofsky to family medicine.

An avid nature photographer, Dr. Plofsky’s artistic passion has provided him with an outlet for his creativity. This outlet has also given him a chance to deepen connections with some of his patients. In fact, his current exhibition, “Our Natural World,”
is dedicated to the memory of his patient “Superman” Sam Sommer, (link to superman blog http://supermansamuel.blogspot.com/ ) who fought a courageous battle with leukemia that he sadly lost in December 2013. Dr. Plofsky will be donating all of the proceeds
from his current photography exhibition to the St. Baldrick’s Foundation, which raises money for childhood cancer research grants.

Here, Dr. Plofsky discusses his two passions—medicine and photography—and the role of the family doctor:

Why did you choose to pursue family medicine? What was it that stood out most about that specialty? Growing up, I saw my pediatrician as a warm and caring individual; he knew us personally and developed a meaningful relationship with our family. As I explored different options in training, I was drawn to family practice because it created similar
opportunities to connect with patients. But it’s also challenging because a family physician must have a firm grasp on a broad base of medical knowledge that the specialty demands. It’s extremely rewarding to take care of individuals and families as they
move through life.

Additionally, my mother was a strong role model. She worked for 40 years as a nurse. Her tireless work at the Whitehall Nursing Home opened my eyes to the field of medicine and what I could do to help others.

What do you enjoy most about your profession?
The most rewarding part is the satisfaction gained from developing strong relationships with my patients and knowing that I’m helping them stay well. The connections that are created as I care for individuals and families are a daily reaffirmation of why I
went into medicine.

What is the most difficult aspect of family medicine?As a physician, we have the knowledge to diagnose and treat many illnesses. Our ability to manage chronic and life-threatening diseases is constantly improving and enhancing our patients’ lives. Unfortunately, we don’t have the treatments for every
illness. As a physician trained to help people get better, it’s extremely difficult to see some patients simply not get better despite our best efforts. This was especially difficult with my patient Sam Sommer because he was so young and I’d been treating
his family for the past 12 years. I’d been Sam’s doctor from shortly after he was born until he passed away not long after his 8th birthday.

In addition to medicine, you are also passionate about photography. What sparked this interest? My interest in photography goes back to high school. I was a staff photographer for my high school yearbook; I specialized in candids and sports images. Over the past seven years, I’ve gone on to develop a passion for photography now as an adult.
My interest in photography stemmed somewhat from the technical challenge it presented and evolved more to the creative exploration it has become.

Why has nature become your chosen subject? For me, nature photography is a passion. First, I love being outdoors, hiking and exploring new areas of our natural world. When I’m taking pictures in nature, I have the opportunity to creatively record what I have seen and can present it to others.
I find this both challenging and rewarding. Spending time outdoors is also relaxing and spiritually uplifting.

Has pursuing this passion impacted the way you approach medicine at all?Indirectly. It has opened up many conversations with my patients about their creative endeavors and hobbies. It has reminded me that we all need to take time to pursue our passions and that you need to set aside time to do this. My own health issues
several years ago helped me to realize that I needed to do this.

Why did you decide to donate the proceeds from this exhibition to St. Baldrick’s?
St. Baldrick’s primary fundraisers are these fun head-shaving events. Sam’s parents, Michael and Phyllis, who are both Reform Rabbis, were involved in one recently called “36 Rabbis Shave for the Brave.” They and 52 other rabbis shaved their heads in support
of this cause. It was such a powerful message and it inspired me to find a way to help them too, so I started my own St. Baldrick’s fundraiser. Sam loved nature and he loved the Heller Center, where my exhibition will run through July and August. With Sam’s
love for nature and my photography, I thought that dedicating my photo exhibit to his memory and using it to help raise money for St. Baldrick’s would be a perfect way to help.

There will be an open house at 1 p.m. Sunday, July 20th at the Heller Nature Center (2821 Ridge Road in Highland Park).

Dr. Plofsky's photos from the exhibit are available online through American Frame. Donations can also be made directly to St. Baldrick's
here.